OVERVIEW

There is a growing number of Australians experiencing, or at risk of homelessness, impacting on around 22,000 people in Victoria on any given day. Homelessness is often concentrated in inner city areas, and in the 2016 homelessness Registry Week survey undertaken in Melbournea there were 161 people sleeping rough. Homeless services in Melbourne and around the country are increasingly struggling to meet demand, compounded by the shortage of accommodation and affordable housing options for people who are homeless. This has significant repercussions for inner city public hospitals such as St Vincent’s Hospital Melbourne (SVHM); people experiencing homelessness are more likely to have complex, compounding health needs and comorbidities, and greater usage of acute health services. Health issues among people who are homeless invariably cluster with, and are exacerbated by other social determinants of health, including trauma, poverty, unemployment and social disconnection. Thus this challenges traditional clinical boundaries and health system responses. At the aggregated level, there is a costly revolving door between homelessness and the health system, and the over-representation of homeless people in hospital statistics has resource as well as equity implications. SVHM is founded on core principles of social justice, human dignity and health care for vulnerable populations hence people who are homeless have always aligned with its core mission and values. Its dedicated and innovative work to meet the health needs of homeless people is widely recognised and highly regarded in Victoria and nationally. Its breadth of contact with, and services for, people experiencing homelessness has evolved over time, and whilst there have been some evaluations of individual programs and services, this is the first evaluation to look at the suite of four key services for people who are homeless. This report presents results of an evaluation of four SVHM homeless services; (i) Assessment, Liaison, & Early Referral Team (ALERT), (ii) Clarendon Homeless Outreach Psychiatric Service (CHOPS), (iii) The Sister Francesca Healy Cottage (The Cottage) and, (iv) Prague House. There were eight specific objectives guiding the evaluation, the essence being to measure, analyse, and document the impact of the services on client outcomes and to make recommendations for how these services may collaboratively strengthen future service delivery.